USAID approved the Detailed Implementation Plan (DIP) of Parivarthan Child
Survival Project covering the Sahibganj District, Jharkhand at Washington DC on
June 5th, 2008. At a meeting on June 5, 2008 at Washington DC five out of
twenty-eight international NGOs were selected from all over the world to present
the DIP for each of their projects under USAID’s Child Survival and Health
Grants Program. EFICOR’s partner CRWRC represented by Ms Nancy TenBroek and Mr
Sanjeev Bhanja, Director- Programmes, EFICOR who presented and defended the DIP
were specially acknowledged by USAID.
USAID, India has selected Jharkhand as one of three focus states for expanding
reproductive and child health, since they have “the greatest unmet needs for
reproductive and child health services.”
Sahibganj which is composed of nine blocks and 1,297 villages, was selected as
the target district for the Child Survival Program due to the tremendous burden
of disease and the lack of health services in the district. Sahibganj is one of
the poorest and least developed districts. Over half of the population (55.3%)
in this district lives below poverty line, and out of 569 districts in India,
Sahibganj has been ranked at 562 affirming the backwardness of the district with
78.4% of the rural population living below poverty line .
Although Jharkhand is a focus state for USAID India, Sahibganj receives limited
assistance due to the difficult access to remote villages. Sahibganj also has a
large tribal population that is disproportionately overlooked by the existing
health system.
The health status of Sahibganj District with respect to Jharkhand State is
bleak. The estimated crude birth rate in Sahibganj is 35.5 (compared to 29.9 in
Jharkhand). The literacy rate in Sahibganj is 37.9%; however, there are
significant differences in literacy rates between men (48.3%) and women (26.8%).
This low literacy rate among women not only has implications for the way health
information should be communicated to women, but it also highlights other
underlying causes of poor health, such as gender inequality which leads to women
and adolescent girls having little or no decision making power regarding sexual
and reproductive rights.
Child bearing imposes health needs and problems on tribal women – physically,
psychologically and socially. In some tribal areas, maternal mortality is
reported to be very high, 460 per 100,000 child births. The high mortality rate
is mainly due to unhygienic practices.
Infant mortality is also extremely high among the tribal populations. In some of
the tribal villages in Rajmahal hills (Sahibganj district) the IMR is as high as
147 per 1,000 live births . The high rate is mainly due to low birth weight,
lack basic knowledge by mothers, poverty, remoteness of the villages and
inaccessibility of health care facilities, infectious diseases such as malaria
and Kala-azar. Vaccination and immunization of infants and children have been
inadequate among tribal groups as well. In addition, extremes of superstitious
religious beliefs and taboos tend to aggravate the problems. The existing public
health infrastructure is grossly inadequate in relation to the population and
geographic spread of the State.
The beneficiary population would consist of 927,770 , which includes 161,950
children under age five and 188,511 women age 15-49 . The project proposes to
Reduce mortality among mothers, newborns and children under the age of five
through building and sustaining community capacity.
The strategic objectives are :
Build organizational and community capacity for a sustainable impact on maternal
and child health.
Improve access to quality maternal and newborn care.
Improve nutrition among children.
Prevent and properly treat infectious diseases among women and children.
These objectives are also EFICOR’s endeavor to align with the Millennium
development Goals to reduce child mortality and improve maternal health.